Hemophagocytic lymphohistiocytosis associated with HBV‐HCV coinfection in adult: Case report

Bendari, Mounia; Delsa, Hanane; Bouanani, Nouama; Jabouri, Rajaa; Darouich, Safaa; Nejjari, S.; Guessous, Fadila; Doghmi, Kamal

doi:10.1002/ccr3.4328

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Moreover, HLH can result from infection with hepatitis viruses, with the majority of cases involving HAV and, less commonly, HBV or HCV infection [92][93][94]. Two systematic reviews of HAV-associated HLH cases have identified hepatomegaly and splenomegaly as distinguishing features of HAV-HLH, as these signs are rarely observed in patients with HAV infection who do not develop HLH [63,95].…”

Section: Hepatitis Virusesmentioning

confidence: 99%

Macrophage Activation Syndrome in Viral Sepsis

Papageorgiou,

Gogos,

Akinosoglou

2024

Viruses

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Macrophage activation syndrome (MAS) is a life-threatening systemic hyperinflammatory syndrome triggered by various infections, particularly viral infections, autoimmune disorders, and malignancy. The condition is characterized by an increased production of proinflammatory cytokines resulting in a cytokine storm and has been associated with poor clinical outcomes. During the COVID-19 pandemic, patients with severe manifestations developed features similar to those of MAS, although these characteristics remained well defined within the lung. Additionally, other viral infections including EBV, the herpes family of viruses, hepatitis viruses, influenza, HIV, and hemorrhagic fevers can be complicated by MAS. The diagnosis and management of the condition remain challenging due to the lack of consensus on specific guidelines, especially among the adult population. Currently, therapeutic options primarily rely on medications that are typically used to treat primary hemophagocytic lymphohistiocytosis, such as corticosteroids and etoposide. In addition, cytokine-targeted therapies present promising treatment options. The objective of this review is to discuss the emergence of MAS in the context of viral infections including, but not limited to, its occurrence in COVID-19.

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Section: Hepatitis Virusesmentioning

confidence: 99%

Macrophage Activation Syndrome in Viral Sepsis

Papageorgiou,

Gogos,

Akinosoglou

2024

Viruses

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“…Human herpes virus (HHV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) are among the most common viruses associated with HLH. However, cases of influenza (H1N1 and H5N1), parvovirus B19, and hepatitis A and C-associated HLH have been reported [ 18 , 19 ]. Various mechanisms have been described as possible drivers for HLH in viral infections [ 20 ].…”

Section: Reviewmentioning

confidence: 99%

Hemophagocytic Syndrome and COVID-19: A Comprehensive Review

Fadlallah¹,

Salman²,

Fadlallah³

et al. 2023

Cureus

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Hemophagocytic lymphohistiocytosis (HLH), a hyperinflammatory hyperferritinemic syndrome, is triggered by various etiologies and diseases and can lead to multiorgan dysfunction and death. There are two types of HLH: primary and secondary. Primary HLH (pHLH) is caused by a genetic mutation resulting in dysfunction in cytotoxic T lymphocytes (CTLs), natural killer (NK) cells, hyperactivated immune cells, and hypercytokinemia. In secondary HLH (sHLH), an underlying etiology is the cause of the disease. Infections, malignancy, and autoimmune diseases are well-known triggers for sHLH. Infectious triggers for sHLH are most frequently viruses, where different mechanisms, including dysregulated CTLs and NK cell activity and persistent immune system stimulation, have been reported. Similarly, in severe coronavirus disease 2019 (COVID-19) patients, a hyperinflammatory mechanism leading to hypercytokinemia and hyperferritinemia has been demonstrated. A similar dysfunction in CTLs and NK cells, persistent immune system stimulation with increased cytokines production, and severe end-organ damage have been reported. Therefore, a significant overlap is present between the clinical and laboratory features seen in COVID-19 and sHLH. However, SARS-CoV-2, similar to other viruses, can trigger sHLH. Hence, a diagnostic approach is needed in severe COVID-19 patients presenting with multiorgan failure, in whom sHLH should be considered.

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